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Dr. S Kulkarni

Radiologist, Mumbai

500 at clinic
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Dr. S Kulkarni Radiologist, Mumbai
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Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; a......more
Hello and thank you for visiting my Lybrate profile! I want to let you know that here at my office my staff and I will do our best to make you comfortable. I strongly believe in ethics; as a health provider being ethical is not just a remembered value, but a strongly observed one.
More about Dr. S Kulkarni
Dr. S Kulkarni is a trusted Radiologist in Opera House, Mumbai. You can visit him at Bay View Clinic in Opera House, Mumbai. Don’t wait in a queue, book an instant appointment online with Dr. S Kulkarni on Lybrate.com.

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Back Bay View 1st floor, 3A Mama Parmanand Marg, Opera House. Landmark: Next to TBZ Jewellers, Opposite Charni Road Station, MumbaiMumbai Get Directions
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Doctor my 13 year old daughter has developed slip disc in her L4 and L5 vertebrae. What should be her treatment?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Disc prolapse at age of 13 years is not common, though it still may occur. Treatment is analgesics, back care, rest and physiotherapy. However, the child needs to be examined before I can suggest precise treatment
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Lumbar Degenerative Disc Disease

MBBS, Diploma In Orthopaedics (D. Ortho), DNB - Orthopedics, mch
Orthopedist, Delhi
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Different methods to treat Disc problems

Hello friends, I am Dr Gaurav Khera. I am an orthopaedic surgeon, doing joint replacements and spine surgeries at the Access healthcare. Now today I will be talking about the lumbar degenerative disc disease. Now it sounds very big, but it is not as complicated as it sounds. It basically is what you people commonly know as a disc disease. So it is a fairly common problem that is seen in our population today. In fact about 30 or 40% of the patients who come to our OPD have lower back pains, some have other disc problems and very commonly seen after 40 years of age and this incidence gradually increases up to 60-70 years of age. The other ecological factors which are associated with this are, first of all smoking, secondly it is, mild to moderate trauma, thirdly its seen in people who lift heavy weights, fourth is obesity, especially central obesity, that is if you have a very heavy waistline.

Now what is Lumbar degenerative disc disease? Now, our spine is composed of multiple bones, which are starting from your neck and they come all the way down to your hip, divided into the cervical, dorsal, lumbar and sacral spine. And between these bones, there are these small pieces of discs, which act as cushions. When your body walks, these act as shock absorbers between your body’s bones. Now this discs, when these come out of their normal place, it gives or presses against the nerves which are passing through these areas and it causes pain. This is what happens in the disc disease. Basically, in the patient it will come as a lower back pain, and this pain will be travelling down to the hip, and it will also be coming down to the legs. Some people complain that as they walk, the pain increases.

They also complain of tingling numbness. They complain that sometimes their fingers or their toes are feeling numb. These are some of the very common symptoms which are being seen. Few people may have only lower back pain, and these are the people who do not have very significant disc disease. Now there are two main causes of the disc disease. First is an inflammatory reaction that occurs in the disc, and second is the micro motion instabilities that occur. Inflammatory reactions may occur as a result of some small traumas which may occur such as when you may injure your back. Such inflammatory reactions occur in the form of small swellings in the body. And micro motion instabilities are when the body ages, the disc which has an outer fibrous thick layer, that degenerates, and as it degenerates, the pulp which is there at the centre, of the discs, tends to degenerate. What I mean is it comes out of its normal space. And as it comes out of the normal place, it comes and tends to press on the nerves and these are the two most common causes.

All disc patients are not to be operated. When we get these patients, the first and foremost investigation that we do is a X-Ray. And if required, we go in for a MRI. Frankly MRI is the known standard to diagnose the disc disease. The findings of a MRI are always coordinated with the clinical findings. Once we have diagnosed that it is a disc problem, we have to establish that what the compression on the nerves is. If the nerve compression is a lot, and if we think that we cannot do anything other than surgery, then we take the patient for a surgery.

If not, we take the patient fro physiotherapy, lifestyle changes and few medications. These medications may carry on for few weeks to few months. And a lot of exercise has to be carried on regularly. Lifestyle changes such as weight loss, stoppage of smoking is very important. And if you can achieve this, then your problems are very easily solved. If you have any queries regarding your disc problems or back pains, then you can get in touch with me for the same.

You can reach me in my clinic, which is there in Indrapuri, by the name of Dr Khera’s Wellness Clinic or you can also contact me through Lybrate for the same. Thank You.
 

3714 people found this helpful

Myth: Brain Damage is Always Permanent

M.Ch, MBBS
Neurosurgeon, Hanumangarh
Myth: Brain Damage is Always Permanent

Myth: Brain damage is always permanent.

Fact: The brain can repair or compensate for certain losses, and even generate new cells.
People once believed that we were born with a finite number of brain cells, and that was it for life; if you damaged any of them you could never get them back. Similarly, many scientists believed that the brain was unalterable; once it was" broken" it could not be fixed. 

Now, of course, we know that the brain remains plastic throughout life, and can rewire itself in response to learning. It can also generate new brain cells under the right circumstances.

Uterine Fibroids - 3 Major Causes

MBBS, MS - Obstetrics & Gynaecology, DNB - Obstetrics & Gynecology, Fellowship in Gynecologic Endoscopy
Gynaecologist, Mumbai
Uterine Fibroids - 3 Major Causes

Uterine fibroids are referred to as benign, abnormal growths which tend to develop in the uterine walls of a woman. The size of such growths can range from a few centimeters to even excess of a few inches. As such, they can cause the uterus to increase to the size of a five month pregnancy. Although, the symptoms of fibroids are not always apparent, they often cause heavy bleeding and pain in women. A recent research concluded that around 60 to 75 percent women contract such fibroids by the age of 50, at least once in their life.

Depending on the site of formation, uterine fibroids are distinguished into different types. Intramural fibroids in the lining of the uterus and subserosal fibroids which develop outside the uterus are the most commonly observed fibroids.

What causes Uterine Fibroids?
Although, the exact reason for the formation of fibroids are obscure, medical professionals have determined certain factors that may affect their formation. Some of them are:
1) Hormones: Progesterone and estrogen, produced by the ovaries regenerate the uterine lining during each menstrual cycle and trigger the growth of fibroids.
2) Family history: If you have had a family history of uterine fibroids, then you are likely to develop the condition yourself as well.
3) Pregnancy: The production of progesterone and estrogen increases during pregnancy which increases the likelihood of fibroids.

What are the signs of this condition?
Depending on the location and size of the tumors, symptoms of such fibroids include:
1) Heavy bleeding and blood clots during periods
2) Pain in the pelvis
3) Frequent menstrual cramps
4) Pressure and pain in the lower abdomen
5) Swelling in the abdomen
6) Pain while intercourse

What is the procedure of treatment?
Ultrasound and pelvic MRI are common diagnostic procedures to check for uterine fibroids. After diagnosis, depending on your age, size of the fibroid and your comprehensive health, the doctor would prescribe you with appropriate medications. Only after medications prove futile, doctors opt for minimally invasive surgeries.

In case you have a concern or query you can always consult an expert & get answers to your questions!

4661 people found this helpful

Uterine Cancer - 4 Treatment Techniques

MBBS, MD - Obstetrtics & Gynaecology
Gynaecologist, Gurgaon
Uterine Cancer - 4 Treatment Techniques

Uterine cancer is also known as endometrial cancer. It is a cancer which begins in the lining of the uterus. The uterus is the part of a woman's body where the fetus develops. Uterine cancer is one of those rare cancers in India, which can be diagnosed in its early stages. This is because excessive vaginal bleeding occurs, thus making it a very serious and an apparent symptom. It is also one of the few forms of cancer which can be cured as removing the uterus is often more than enough to cure the patient of uterine cancer.

Here are the causes, diagnosis and treatment of uterine cancer:

Causes:

The exact cause of uterine cancer is not yet known, however, there is a theory on what causes uterine cancer. Hormones in a woman's body have been thought to increase the chances of getting uterine cancer. This is because it has long been thought that having high levels of estrogen is the cause of uterine cancer. Increased estrogen thickens the endometrium and thus, increases the likelihood of uterine cancer.

Diagnosis:

1. Pelvic exam: This is an examination in which the vagina, bladder, rectum and uterus are scanned for lumps. If they are found, it might be due to uterine cancer.
2. Pap test: A pap test is a special test designed to scan for uterine cancer.
3. Transvaginal ultrasound: A transvaginal ultrasound uses high-intensity sound waves so that pictures of the uterus can be taken.
4. Biopsy: During a biopsy, the doctor will remove tissue from the endometrium and it will then be analyzed for cancerous growths.

Treatment:

1. Surgery: This is the most common treatment as it removes the entire uterus and prevents the spreading of the cancer.
2. Chemotherapy: Chemotherapy involves giving drugs which kill cancerous cells. They are given through either an intravenous line or even in pill form.
3. Hormone therapy: This is a therapy in which either progesterone levels are increased or estrogen levels are decreased.
4. Radiation therapy: In this treatment, high energy laser beams are used to destroy cancerous cells. If you wish to discuss about any specific problem, you can consult a Gynaecologist.

2999 people found this helpful

I am 33 and my body has became very stiff due to no physical exercise. I have slip disk and neck ailments. Also mental tension getting worse. But need to come over this. What could be the starter guidelines for getting started with Yoga/Meditation.

B.Sc. - Dietitics / Nutrition, Nutrition Certification,Registered Dietitian
Dietitian/Nutritionist, Delhi
I am 33 and my body has became very stiff due to no physical exercise. I have slip disk and neck ailments. Also menta...
The best way to get started is with pranayam. Do daily breathing exercises for half an hour and then start with suryanamaskar. Do atleast 21 cycles of suryanamskar. You will start seeing the results within 15 days.
1 person found this helpful
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The 4 Stages Of Uterine Cancer

DNB (Obstetrics and Gynecology), MD - Obstetrtics & Gynaecology, MBBS
Gynaecologist, Delhi
The 4 Stages Of Uterine Cancer

The uterus is a very important organ within the human reproductive system as this is the chamber where an embryo grows into a baby. Due to a multitude of factors, the incidence of uterine cancer has been on the rise. Let's look at some of its symptoms.

Symptoms of uterine cancer
When cells within the uterus grow abnormally and turn malignant, it may be termed as uterine cancer. This may be in the form of a fibroid or tumor or be part of the uterine tissue itself. It may be caused due to a multitude of factors such as late menopause, radiation exposure, estrogen treatments and many others. Some of the common symptoms for uterine cancer could be:

a. Pain in the abdomen, lower back and especially the pelvic area.
b. Pain during urination,
c. Weight loss without any apparent reason
d. Vaginal bleeding with or without discharge
e. Pain during sex

Stages of uterine cancer:
Before we understand the stages of uterine cancer you need to know how doctors diagnose the various stages. This is done by the three following steps in the TNM method:

Tumor - Doctors try and search for tumors and locate them within the uterus, estimate its size and whether it is malignant or not.

Node - If the tumor is malignant, then doctors try to find out whether the tumor has reached the lymph nodes or not.

Metastasis - Doctors look for Metastasis which is whether the cancer has spread to other organs within the body and to what extent.

Stages of cancer - Cancer is primarily grouped in five stages from 0 to V according to the T, N and M stages mentioned below.

Stage 0 - This is a very early stage of cancer where the cells have malignant growth but are still small in number and haven't spread anywhere.

Stage I - If the cancer has developed a little but is restricted within the uterus, it is considered as stage one. This is also further divided into Stage 1A and 1B.

Stage II - When the cancer has started spreading but only to some parts of the cervix from the uterus, it is diagnosed as stage 2 uterine cancer.

Stage III - Categorized into Stage IIIA, Stage IIIB, Stage IIIC1 and Stage IIIC2, it is primarily where the cancer has spread to other organs but it is only limited to the pelvic area.

Stage IV A - When the cancer has gone beyond the pelvic area and also spread to the rectum and balder area.

Stage IV B - This is where the cancer has metastasized in the groin area or gone to other organs within the body as well.

I'm 42 years old. I'm suffering from l-s 4 slip disc. please tell what can be done?

MBBS, MS - Orthopaedics
Orthopedist, Delhi
(A) Sleep on a hard bed with soft bedding on it. (B) Use no pillow under the head. (C) Kindly take BioD3 Max 1 tab dailyx10 Paracetamol 250mg OD & SOS x5days (D) Do back(spine)/shoulder/knee exercises (E)Make sure you are not allergic to any of the medicines you are going to take (F) Do not ignore it. It could be beginning of a serious problem. (G) If no relief in 4_5 days,then contact me again. (H) Contact your family doctor or nearest hospital for emergency help.
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I have a back disc doctor has advised to take complete bed rest for 3 months but I am preparing for competitive exam which is not possible. is there any way so that I will be ok?

DNB (Orthopaedics), Diploma In Orthopaedics (D. Ortho), MBBS
Orthopedist, Gurgaon
The current philosophy of treating disc problems is to enforce strict bed rest for a week to 10 days,
2 people found this helpful
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Brain Mapping Surgery - Why It Is Performed?

MCh - Neurosurgery, MBBS
Neurosurgeon, Chennai
Brain Mapping Surgery - Why It Is Performed?

Brain mapping is a technique where the biological quantities of a human brain are represented as spatial quantities resulting in maps. As with many other medical technologies, brain mapping is fast-evolving as well. Among several uses, brain mapping is chiefly used while performing surgery on the brain.

When surgery is to be performed on the brain such as surgery for epilepsy, the surgeon would want to comprehend how the brain areas are affected by seizures. The surgical intervention is meant for removing as much as seizure focus as possible while preserving crucial functions like understanding, speech, vision, movement, and sensation.

Why is brain mapping performed?
Brain mapping is a process which helps in identification of functions of various parts of the brain. Mapping the brain by stimulating different areas of the brain areas can aid in creating a map for a particular person. The map allows the doctor in understanding what parts of the brain are responsible for performing critical functions including sensation, movement, speech and other functions.

Which functions of the brain can be mapped electrically?
Typical areas of the brain which have motor, language, visual and sensory functions are needed to be mapped. When current is applied to a single area at a time, the doctor understands which part of the brain is responsible for which function.
When the patient is not able to speak due to the current, then the area is likely to be crucial for language function. If the limbs, face or trunk of the patient stop moving as the current passes, the area that is tested is responsible for movement. On the other hand, if the individual experiences tingling, numbing, and other sensations when the current is applied, it means that a sensory region is discovered.

How is electrical brain mapping performed?
Electrical brain mapping for guiding brain surgery for epilepsy can be performed in two distinct processes: directly during the surgery or in a two-stage procedure.

Two-stage procedure:
In the first stage of the process, the surgeon creates an opening in the skull which helps in exposing the surface of the brain. Small electrical contacts or electrodes are placed on the brain surface even though no brain tissue is removed. As soon as the electrodes are in the right position, the scalp is closed. The electrodes not only record the seizure of the patient electrically but also allow mapping of various areas of the brain. The last stage is surgery where abnormal brain tissues are removed.

Brain mapping process during surgery:
Electrical brain mapping may also be performed during the surgery which exposes part of the brain. This is termed as intraoperative brain mapping since it occurs while performing the main operation. The process of mapping may last for an hour to several hours at a stretch.

Brain mapping is also used to diagnose neurodegenerative diseases like Alzheimer’s and Parkinson’s. In these cases, the brain map shows extreme shrinkage of the brain due to tissue loss. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.

3381 people found this helpful

I am a 25 years old male, I have been suffering from bulging disk at l5-s1. I have been resting for 2 months, now my neck has started paining too and left pelvic joint is making popping sound everytime it is bend. So I got my blood acid checked. And its been 8 for last two months, I have been drinking like 6 lts water everyday. Is uric acid main reason of pain? And how can I get it down as I don't want to start the medicine so early in life and drinking water is not working. Please suggest, my career is suffering a lot.

MBBS, MS - Orthopaedics
Orthopedist, Delhi
Requires detailed examination and investigation. Preliminary investigations suggested: hb, tlc, dlc, esr, blood sugar fasting & pp, uric acid vit d urine r/e x-ray of the affected part. Anyway it may be tried sleep on a hard bed with soft bedding on it. Spring beds, folding beds or thick mattress are harmful use no pillow under the head. Do hot fomantation paracetamol 250mg od & sos x 5days. Caldikind plus 1tab od x10. Do neck, back, knee & general exercises. It may have to be further investigated. Do not ignore it. Let it not become beginning of a bigger problem. Make sure that patient is not allergic to any of the medicines that he/she is going to take. If it does not give relief in 4-5days, inform.
5 people found this helpful
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Causes and Symptoms of Uterine Fibroids

Fellowship In Minimal Access Surgery, MS - Obstetrics and Gynaecology, MBBS
Gynaecologist, Hyderabad
Causes and Symptoms of Uterine Fibroids

Uterine fibroids are referred to as benign, abnormal growths which tend to develop in the uterine walls of a woman. The size of such growths can range from a few centimeters to even excess of a few inches. As such, they can cause the uterus to increase to the size of a five month pregnancy. Although, the symptoms of fibroids are not always apparent, they often cause heavy bleeding and pain in women. A recent research concluded that around 60 to 75 percent women contract such fibroids by the age of 50, at least once in their life.

Depending on the site of formation, uterine fibroids are distinguished into different types. Intramural fibroids in the lining of the uterus and subserosal fibroids which develop outside the uterus are the most commonly observed fibroids.

What causes Uterine Fibroids?
Although, the exact reason for the formation of fibroids are obscure, medical professionals have determined certain factors that may affect their formation. Some of them are:
1) Hormones: Progesterone and estrogen, produced by the ovaries regenerate the uterine lining during each menstrual cycle and trigger the growth of fibroids.
2) Family history: If you have had a family history of uterine fibroids, then you're likely to develop the condition yourself as well.
3) Pregnancy: The production of progesterone and estrogen increases during pregnancy which increases the likelihood of fibroids.

What are the signs of the condition?
Depending on the location and size of the tumors, symptoms of such fibroids include:
1) Heavy bleeding and blood clots during periods
2) Pain in the pelvis
3) Frequent menstrual cramps
4) Pressure and pain in the lower abdomen
5) Swelling in the abdomen
6) Pain while intercourse

What is the procedure of the treatment?
Ultrasound and pelvic MRI are common diagnostic procedures to check for uterine fibroids. After diagnosis, depending on your age, size of the fibroid and your comprehensive health, the doctor would prescribe you with appropriate medications. Only after medications prove futile, doctors opt for minimally invasive surgeries. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.

2790 people found this helpful

As per my MRI report for lumber spine, disc protrusion seen at L5-S1 indenting anterior thecal sac and narrowing left neural recess. Disc hydration is Los at L5-S1. I have severe lower back pain for last one month. What is the ideal plan for treatment?

BPTh/BPT
Physiotherapist, Delhi
As per my MRI report for lumber spine, disc protrusion seen at L5-S1 indenting anterior thecal sac and narrowing left...
Take bed rest for 15 days. Consult physio they will guide you better. Avoid forward bending. Use hot pack for 15 mint at lower back.
3 people found this helpful
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Am 24 years old and facing disc bulge from past 4 years (L4, l5, l6) I have taken treatment with exercises, massages and Physio therapy. Which is best way to cure in a quick time.

MBBS, MS - Orthopaedics, DNB (Orthopedics)
Orthopedist, Mumbai
Continue your physiotherapy and avoid bending forward and lifting heavy weights, do regular back and core strengthenin exercise, take a healthy diet of calcium and vitamin d usually slipped discs regress on their own in a period of 6 to 8 months.
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Brain Structure May Help Boost Care

DIABETES EDUCATOR, PGDND, RMP -ALTERNATIVE MEDICINE, MEDICAL TRANSCRITPTINIST, M.SC, Msc nutrition
Dietitian/Nutritionist, Bangalore
Brain Structure May Help Boost Care

Becoming a mum can lay down a whole lot of stress on you. But now you know that your brain is going to help you with all the adjustment s! ah ah a relief you get when your baby gives you a hug by kissing your cheecks the joy you get is amazing and gratitude to the almighty creater

1 person found this helpful

Rejuvenates The Bones, Muscles and Nerves by Patra Pinda Swedan

B.A.M.S.
Ayurveda, Dehradun
Rejuvenates The Bones, Muscles and Nerves by Patra Pinda Swedan

Patra panda sweda(ela kizhi) is a specialized therapy which is performed for the diseases related to Bones, muscles and nerves. Patra means leaves of medicinal plants. Pinda means a bolus. Sweda means Fomentation or sudation. The swedana karma or sudation therapy which is given by using a bolus which is prepared by the different combination of medicinal leaves which is processed with medicinal oil along with the medicinal herbs is called as patra panda sweda or ela kizhi. This procedure is unique, which comprises both snehana (oleation) and swedana (sudation) (snehayukta swedana)

Benefits of Patra Pinda Sweda:
It strengthens and rejuvenates the bones, muscles and nerves
Strengthens the tissues
Increases the circulation
Provides color and complexion of the skin
Helps to Reduce pain, inflammation and stiffness of the muscles
Induces good sleep and reduces the stress.

INDICATIONS:
Paralysis
Joint stiffness
Swelling
Sciatica
Cervical spondylitis
Lumber spondylitis
Back pain
Arthritis
Sprains and cramps

8 people found this helpful

Top 4 Symptoms Of Liver Cancer

MD - Oncology
Oncologist, Hubli-Dharwad
Top 4 Symptoms Of Liver Cancer

If you are concerned about liver cancer, you should know that most people do not experience signs and symptoms of the cancer in the early stages. Liver cancer is a form of cancer which occurs in the cells of the liver. There are various types of cancer which can develop in the liver. Hepatocellular carcinoma (HCC) is the most common liver cancer which begins in the hepatocyte, which is the main liver cell.

Symptoms-

Usually there are no specific primary stage symptoms of liver cancer. Some symptoms which may develop include the following:

  1. Unusual weight loss is observed

  2. Loss of appetite and developing food aversion

  3. Pain in the upper abdomen

  4. Nausea followed by vomiting

  5. General weakness with intense fatigue

  6. Swelling in the abdomen

  7. The skin may become yellow

  8. White and chalky stools are likely

Causes-

In most cases, the causes of liver cancer cannot be clearly determined. In some cases, the cause is known, such as chronic infection with the hepatitis virus, which may lead to liver cancer. Liver cancer occurs when the liver cells undergo changes or mutations in their DNA structure. DNA mutations lead to changes in instructions of chemical processes taking place in the body. The cells may grow out of control and develop into a cancerous tumour.

Risk Factors-

There are several factors which enhance the risk of liver cancer. They are as follows:

  1. Chronic infection with hepatitis B or hepatitis C increases the risk of liver cancer.

  2. A progressive and irreversible condition known as cirrhosis leads to scar tissue formation in the liver, increasing the risk of liver cancer.

  3. Certain inherited liver diseases such as Wilson’s disease and hemochromatosis also increase the chances of liver cancer.

  4. People with diabetes are also at a greater risk of having liver cancer.

  5. Non-alcoholic fatty liver disease (NAFLD), which is the accumulation of fat in the liver, also increases the chances of getting this condition.

  6. Excessive alcohol consumption is another factor which causes irreversible damage to the liver and the chances of getting liver cancer get boosted.

  7. Exposure to aflatoxins, which are poisons produced by molds growing on poorly stored crops, make you more likely to get liver cancer.

Several tests and procedures are carried out for the diagnosis of liver cancer. These include blood tests for diagnosing liver function problems, and imaging tests such as ultrasound, CT scan and MRI scan.

9 people found this helpful

She is 63 years old suffering from diabetes-on Insulin+other allopathy medicines but the sugar level running from 70 to 200 and more. Today fasting 90 but PP is going high between 200 to 300. She is on Insulin from last 15 years. Can she be treated with you? And I am also suffering from Slip Disc. L4 L5 S1 and taken 15 days Ayurvedic treatment such as Katibastyi, Malish, Steam bath etc but there is nothing complete and permanent. Please advise us to permanent treatment.

PDDM, MHA, MBBS
General Physician, Nashik
She is  63 years old suffering from diabetes-on Insulin+other allopathy medicines but the sugar level running from 70...
This means either her diet is wrong or she is not receiving proper treatment kindly mention ongoing treatment in detail and revert. Slip disc is difficult to treat but you should use lumbosacral belt and proper posture is really important in your case. Avoid massages by inexperienced people.
1 person found this helpful
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I have a disc bulge at L4-L5 and L5-S1, its being more then 7 months now. My physiotherapy session is going on but i still have pain and weakness in my legs

M.Ch, DNB (Orthopedics), MBBS
Orthopedist, Mohali
You need and MRI and clinical assessment and may end up having a surgery if you have weakness which has not improved on censervative treatment for 7 months.
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